Sports clubs have been reporting several organizational problems in recent decades (e.g., recruitment and retention of members and volunteers). At the same time, certain sports clubs have professionalized their strategies, structures, processes, and staff. However, previous research has not analyzed whether the professionalization of sports clubs is related to their organizational problems. Therefore, this study conducts, in the first step, a cluster analysis based on three dimensions of professionalization to identify professionalization types among sports clubs. In the second step, it examines differences in organizational problems among the identified professionalization types. The main findings are that (1) sports clubs with paid staff report fewer problems with recruiting and retaining members but more problems with finances than sports clubs that rely on voluntary work, and (2) sports clubs with increased professionalization of human resources management (HRM) and strategy have fewer problems with recruiting and retaining board members and coaches than sports clubs with low professionalization of HRM and strategy. These results show that professionalized sports clubs have different, but not necessarily fewer, organizational problems.

IntroductionFever is the chief complaint of up to one-third of all paediatric office visits in many places. The high number of consultations at our emergency department (ED) led us to hypothesise that this increase was due to febrile paediatric patients with lower urgency seeking medical advice.MethodsWe retrospectively analysed the number and characteristics of patients 3 months to 5 years of age consulting for a body temperature of 38.5°C or higher during the 6 winter months of 2011–2012.ResultsTwenty-four percent of all consultations were requested by the patients included in our group. None of the 835 patients had to be hospitalised, 95% of these patients had additional respiratory or gastrointestinal symptoms, 36.7% required antibiotic therapy, and 17.6% (laryngitis and lower respiratory tract infection (RTI)) required temporary respiratory support. A total of 56.2% of patients sought advice outside of the normal working hours.ConclusionThe majority of patients had fever accompanied by additional symptoms justifying a medical consultation. However, most of these did not require the infrastructure of an ED for their health care problem and probably visited the ED because of the open hours.

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Introduction Nonprofit sports organisations are valuable sports providers in most European countries. In 2017, there were over 60 million European active sports club members (Nagel et al., 2020). Through the consumption behaviour of this great number of people practicing sports, sport might have a negative impact on the environment (McCullough et al., 2020). Therefore, national sports federations (NSFs), overarching the sports clubs and engaging in sports policy issues, could be crucial when it comes to taking measures concerning the environmental sustainability of sports. Indeed, several NSFs have already launched programmes for environmental sustainability (e.g. Swiss Hang- and Paragliding Association [SHV]). This might be somehow surprising, since the nonprofit organised sport is traditionally primarily committed to the interests of its members and the sport as its core business (Thiel & Mayer, 2009). Thus, the following study addresses the questions, to what extend policies of environmental sustainability appear on the agendas of NSFs and which driving factors are relevant for its agenda setting, formulation and subsequent decision making. Knowledge about those processes is especially important since they are prerequisites for the implementation of environmental policies. Literature review and theoretical background Concerning nonprofit sports organisations and sustainable development, especially the field of social sustainability (e.g. Nagel et al., 2020) has been widely researched. Environmental sustainability however has only limitedly been analysed in this context. Describing the current state of commitment of NSFs to environmental sustainability, it has been found that Belgian NSFs show a rather low commitment, whereas low-intensity initiatives (e.g. recycling of sport equipment) constitute the majority of the identified actions (Hugaerts et al., 2022). The same pattern could be shown in Scandinavia. Sandvik and Seippel (2022) explain this partly with the absence of NSFs’ perceived urgence of environmental problems with direct consequences for the associations’ activities and the lack of institutional pressures. However, so far, there is hardly any knowledge about which factors are relevant for environmental policies being set on NSFs’ agendas, formulated, and decided upon, even though those processes are important as they precede the actual implementation of policies. Considering agenda setting, policy formulation and decision making processes, this study is based on the Multiple Streams Approach with two coupling phases (MSA) of Herweg et al. (2015). For “an ideas’ time to come”, the approach identifies the coupling of three different processes as important. Policies arise, when issues are perceived as problematic (problem stream; e.g. image issues) and depend on the political context of the policy and agenda (political stream, e.g. composition of board). The policy stream contains existing ideas and enables the survival of certain ideas (e.g. idea of developing a climate strategy). Finally, policy entrepreneurs’ agency is necessary to couple the streams and create agenda windows, which allow items to rise onto the decision agenda. In a following second phase, the re-coupling of the same streams and engagement of policy entrepreneurs enables policies to be formulated, decided upon, and eventually be implemented. Methods To observe those processes, we decided to conduct an in-depth qualitative case study with a NSF, that has recently discussed, formulated, and decided upon environmental policies. Since the hang- and paragliding sport is depending on a natural environment affected by climate change, the SHV seemed to be an interesting case for our study, where such processes might already have taken place. The association is committed to the interests and sustainable practice of free flight. It has 112 club and 20,000 individual members, maintains an office with 14 employees and is headed by a board of directors, currently with seven members. Document- and archive entries allowed us a first overview of existing measures of environmental sustainability and the appearance of the topic on the NSF’s agenda. We conducted semi-structured expert interviews with six decision makers of the SHV and with a representative of the umbrella organisation of the Swiss sports system to gain a deeper understanding of the agenda setting, formulation and decision making of environmental policies in the SHV. We then applied causation coding (Miles et al., 2020) to analyse the data, considering a data-led as well as a theory-based coding process along the concept of the MSA. Findings The SHV's commitment to environmental sustainability is based primarily on two pillars: the protection of biodiversity and access to nature on one hand and climate commitment on the other. Whereas voluntary agreements about wildlife rest areas have been made since 1995, climate protection policies are broadly discussed as a part of the strategy and implemented on an operative basis in different departments since the creation of the position of an environmental officer in 2017. If not forced by external political pressure (e.g. flight restrictions), the agenda setting of environmental sustainability (e.g. climate commitment) in the SHV seems to be pushed primarily by the engagement of individual policy entrepreneurs. Policy entrepreneurs thereby mainly highlight the importance of addressing the issue to ensure the long-term survival of the sport and the association (problem stream). The perceived member interests seem to be able to facilitate or impede the agenda setting of the topic (political stream). Nevertheless, members do not appear to be the central entrepreneurs when it comes to actively promoting policies of environmental sustainability onto the agenda. The ideas for such policies rather seem to be found in the practice of similar other NSFs (policy stream). The board of management seems to be less crucial for this process of agenda setting. When it comes to formulation and decision making however, the importance of the board of management is structurally implied. Even though the General Assembly approves amendments and the management of the board, the latter issues directives. Since members of the board do not yet seem to have the necessary knowledge about environmental sustainability to feel competent enough to make the required decisions, thorough information provided by the environmental officers appears to be important. Actors of the association describe policy formulation as a long process, where, in order to make the members of the board feel comfortable enough to make decisions, policies of environmental sustainability “must become a topic first over time”. When it comes to decision making about environmental policies, the (political) background of the members of the board are crucial and can promote or hinder certain decisions. Nevertheless, after getting enough information, suggestions from the administrative office are mostly accepted. Discussion Therefore, engaged policy entrepreneurs seem to be crucial for agenda setting, formulation and, through the impact of their suggestions, decision making processes of environmental policies in the SHV. Policy entrepreneurs do show engagement for their favoured policies even if they are not responsible for that specific topic in the association, but the structural implication of positions in connection with sport- and socio-political developments can additionally promote environmental policies. Even though the agenda setting of such policies does not seem to be a bottom-up process, consistent with the understanding of NSFs as interest-oriented organisations, perceived member interests are central in all three processes. Thereby functional objectives (e.g. enabling sport) are predominant to normative reasons (e.g. environmental responsibility). Furthermore, there seem to be processes that might be explained by the concept of mimetic isomorphism (DiMaggio & Powell, 1983), i.e. the orientation towards practices of similar NSFs in order to gain legitimacy. This pilot study allows an in-depth investigation and enables a first review of the used theoretical and methodological approach. It identifies crucial factors when promoting the agenda setting, formulation and decision making for environmental sustainability in NSFs and utilising the potential of the nonprofit organised sports setting and its leverage in society. It is presented as part of a broader follow-up multiple case study with eight NSFs and a cross-case comparison. Further research must be conducted to allow statements about other types of NSFs (e.g. other types of professionalisation, indoor sports) and further stages of the policy cycle, i.e. the implementation of the policies. References DiMaggio, P. J., & Powell, W. W. (1983). The iron cage revisited: Institutional isomorphism and collective rationality in organizational fields. American Sociological Review, 48(2), 147–160. Herweg, N., Huss, C., & Zohlnhöfer, R. (2015). Straightening the three streams: Theorising extensions of the multiple streams framework. European Journal of Political Research, 54(3), 435–449. https://doi.org/10.1111/1475-6765.12089 Hugaerts, I., Scheerder, J., Zeimers, G., Corthouts, J., van de Sype, C., & Könecke, T. (2022). Are sport organisations environmentally sustainable? A website analysis of sport federations in Belgium. European Sport Management Quarterly. Advance online publication. https://doi.org/10.1080/16184742.2022.2093391 McCullough, B. P., Orr, M., & Watanabe, N. M. (2020). Measuring externalities: The imperative next step to sustainability assessment in sport. Journal of Sport Management, 34(5), 393–402. https://doi.org/10.1123/jsm.2019-0254 Miles, M. B., Huberman, A. M., & Saldaña, J. (2020). Qualitative data analysis: A methods sourcebook (4th ed.). SAGE. Nagel, S., Elmose-Østerlund, K., Ibsen, B., & Scheerder, J. (Eds.). (2020). Functions of Sports Clubs in European Societies: A Cross-National Comparative Study. Springer. Sandvik, M. R., & Seippel, Ø. (2022). Framing of environmental issues in voluntary sport organizations. Environmental Politics. Advance online publication. https://doi.org/10.1080/09644016.2022.2075152 Thiel, A., & Mayer, J. (2009). Characteristics of voluntary sports clubs management: A sociological perspective. European Sport Management Quarterly, 9(1), 81-98. https://doi.org/10.1080/16184740802461744